By Ginnie Graham, Staff Writer, Tulsa World, January 26, 2006
TULSA - - Oklahomans have too few choices for long-term care, which could result in $1.2 billion in annual Medicaid costs by 2020, a panel of national experts agreed Wednesday at the Doubletree Hotel Downtown.
An examination of the current long-term care system and recommendations for improvements were presented at a forum attended by several lawmakers. A team of long-term care experts has been studying Oklahoma's system for more than a year.
Robert Mollica, senior program director for the National Academy for State Health Policy, said states with model long-term care programs have spent nearly 20 years designing and implementing their systems.
Expanding the options for home- and community-based services, in addition to assisted-living and nursing home facilities, dominated the discussion.
"Spending is going to increase," Mollica said. "But if you can broaden the array of services, you can reduce that growth over time. It's important for people to have choice, or else you end up spending money on services people don't want."
Home- and community-based services are less expensive than nursing-home care and are cited in surveys as a first choice among consumers.
In Oklahoma, about 22,700 residents receive Medicaid funding at a nursing facility, costing about $448 million. About 16,500 residents receive home-based care through the Medicaid Advantage waiver program at a cost of about $106 million.
About 85 percent of the state's Medicaid funding goes to nursing home care.
As a comparison, the state of Washington has fewer than 12,000 residents in nursing homes and 37,000 in home- and community-based care. It has a population of about 5.9 million, compared with Oklahoma's 3.5 million.
Washington started refining its long-term care system in the 1970s.
"Change doesn't happen overnight," Mollica said. "It helps to set benchmarks and goals to shoot for."
Recommendations include making spending more equitable between nursing homes and home- and community-based services; placing Medicaid funding for long-term care in one state agency; creating more services to prevent unnecessary and premature nursing care; and fostering more collaboration among state agencies and providers.
The present system makes it easier to enter a nursing home than to have home- or community-based care. A recommendation suggests determining Medicaid eligibility before entering long-term care, with counseling on the options and a transition plan.
Lawmakers attending were Sens. Bernest Cain, D-Oklahoma City, and Brian Crane, R-Tulsa, and Reps. Lucky Lamons, D-Tulsa, Jeannie McDaniel, D-Tulsa, Ron Peters, R-Tulsa, and Kris Steele, R- Shawnee. Other participants included representatives from nonprofit organizations, the Governor's Office, the city, providers and long-term care consumers.
For more information about the report, call the Tulsa Metropolitan Human Services Commission at 585-5551 or the Long Term Care Authority at 583-3336.
